RESUMEN
South Africa [SA] is experiencing a rapid epidemiologic transition as a consequence of political, economic and social changes. In this study we described, based on hospital data, the mortality patterns of Non communicable Diseases [NCD], Communicable Diseases [CD], the NCD/CD ratios, and the trends of deaths. We conducted a cross-sectional survey of all deaths occurring in several public hospitals in the Eastern Cape Province of SA between 2002 and 2006. Causes of deaths were coded according to the ICD 10 Edition. A total of 107380 admissions responded to the inclusion criteria between 2002 and 2006. The crude death rate was 4.3% [n=4566] with a mean age of 46 +/- 21 years and a sex ratio of 3.1 men [n=3453]: 1 woman [n=1113]. Out of all deaths, there were 62.9% NCD [n=2872] vs. 37.1% CD [n=1694] with NCD/CD ratio of 1.7. The ratio NCD/CD deaths in men was 1.3 [n=1951/1502] vs. NCD/CD deaths in women of 1.9 [n=735/378]. The peak of deaths was observed in winter season. The majority of NCD deaths were at age of 30-64 years, whereas the highest rate of CD deaths was at age< 30 years. The trend of deaths including the majority of NCD, increased from 2002 to 2006. There was a tendency of increase in tuberculosis deaths, but a tendency of decrease in HIV/AIDS deaths was from 2002 to 2006. Non-communicable diseases are the leading causes of deaths in rural Eastern Cape province of SA facing Post-epidemiologic transition stages. We recommend overarching priority actions for the response to the Non communicable Diseases: policy change, prevention, treatment, international cooperation, research, monitoring, accountability, and re-orientation of health systems
RESUMEN
To estimate the prevalence of diabetes mellitus [DM], impaired fasting glucose [IFG], and impaired glucose tolerance [IGT], and to determine the risk factors of DM among urban and rural areas of Kinshasa Hinterland Data were collected from a multistage random sample cross-sectional surveys of adult black Africans from Kinshasa region DR Congo with the help of a structured questionnaire, physical examinations and blood samples, using the WHO stepwise approach and the new criteria of WHO to define glucose intolerance. Prevalence rates were adjusted using the standard world population of Waterhouse and the standard population of Kinshasa region. A total of 9770 subjects age >/= 12 years participated [response rate of 90.3%] in this study. Age-adjusted rates to world population of IFG, IGT, DM by fasting plasma only, DM by 2h-load test only, and all cases of DM were 9.3%, 9.6%, 16.1%, 8.4% and 25.3%, respectively. Male sex, rural residence, total obesity, abdominal obesity, viral infection, milk intake, and kwashiorkor were the univariate risk factors of all cases of DM. Adjusted for confounders, advancing age, rural-urban migration, physical inactivity, smoking, abstinence of alcohol, low intake of fruits-vegetables, family history of DM, refined sugar intake, high social class, high intake of animal fat and protein, and stress, were the independents determinants of all cases of DM. This study observed epidemic rates of glucose intolerance. Primary prevention through lifestyle changes is needed to control DM among Africans under demographic and nutrition transition